What Causes Angina Pectoris?

Angina pectoris is a clinical syndrome primarily characterized by episodic chest pain or discomfort. The pain is typically described as a dull, oppressive, or squeezing sensation in the precordial region; however, some patients may experience only chest tightness. So, what causes angina pectoris? Let’s explore this together.

Causes of Angina Pectoris

The primary cause of angina pectoris is an imbalance between myocardial oxygen supply and demand, leading to anaerobic metabolism in cardiac myocytes. This process generates chemical substances that stimulate cardiac nerve endings, resulting in pain. Such imbalance may arise from either inadequate supply (e.g., coronary artery spasm or stenosis) or excessive demand (e.g., vigorous physical exertion, severe fatigue, or intense emotional stress). In daily life, factors such as extreme emotional agitation, exposure to cold wind on the face, excessive straining during defecation, outdoor activity in cold weather, or prolonged squatting followed by sudden standing can all increase myocardial oxygen demand. Therefore, it is advisable to avoid or carefully manage these triggers.

Treatment of Angina Pectoris

Pharmacological treatment for angina pectoris primarily involves anti-ischemic agents, including nitrates (e.g., nitroglycerin, isosorbide dinitrate), calcium channel blockers (e.g., verapamil, amlodipine, flunarizine), and beta-blockers (e.g., propranolol, metoprolol, carvedilol). These medications constitute the cornerstone of angina therapy. Additionally, patients often require combination therapy with angiotensin-converting enzyme inhibitors (e.g., captopril, enalapril), antiplatelet agents (e.g., aspirin, clopidogrel), and lipid-lowering drugs (e.g., rosuvastatin, fenofibrate). Such regimens help prevent myocardial infarction and improve exercise tolerance.

Patients are advised to limit intake of high-fat foods—including egg yolks, chicken liver, pork liver, crab roe, butter, and coconut oil—as these may adversely affect hyperlipidemia. Instead, they should consume fresh fruits rich in vitamin C, such as bananas, lemons, and apples. Foods high in dietary fiber—such as fish, eggs, lean meat, and spinach—are also recommended. Furthermore, adopting a pattern of eating smaller, more frequent meals—and avoiding overeating—is strongly encouraged.

The above provides an overview of the causes of angina pectoris.